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Post-op expectations

User
Posted 31 Oct 2020 at 23:24

Hello all, 

 

My dad (age 64) was diagnosed with PCa (glenson score 4+3, PSA around 3, MRI shows no signs of spread). He is having a Robotic Radical Prostatectomy in the coming weeks. 

We are traveling for his surgery, so we will be in a hotel. We will have a kitchenette-type of situation with a refrigerator, microwave, a little stovetop, and dishwasher.

My first question is what will he feel like eating in the first few days after surgery? I am thinking the standard white diet, but am unsure and google results yield no answers. 

My second question is more about what we should expect his condition to be after surgery? Will it be a quick recovery so we can head back home in a few days (he wants to spend as little time as possible away from home)? FYI, his local urologist will take out his catheter if he chooses to come home and not stay for his surgeon to take it out. 

I am just looking for any words of wisdom about what I should expect from him after surgery and the best way to support him. 

 

Thanks so much in advance! 

User
Posted 01 Nov 2020 at 09:00

Depending on the time of his OP, he should be allowed to return home the following day/pm. He will have a catheter and will be given a course of injections that he will have to administer for about 4 weeks. He will also be told to use paracetamol/ibuprofen as required. 

I expect his diet will revert to normal after only a few days. As you say, he may prefer a basic simple style for the first couple of days.

You say that the local Urologist / Specialist Nurse will remove the catheter ( after approx 7 - 10 days) so make sure that you have an appointment for this. Dad will be relieved to see the back of it !!!

User
Posted 01 Nov 2020 at 11:32
Correction to ProSixty's response - dad might have injections to administer or he might not.

He may have a lot of pain in his upper back / shoulders- this is caused by the gas that they pump into him during the op. Peppermint tea will help. Not sure about 'white' foods - what he will need is lots of roughage to help him go to the toilet ... constipation is the enemy.

No one can say when he will be fit to travel - some men would be able to a couple of days post op while others may not be up to it for 3 or 4 weeks. Also, no way of predicting the impact of incontinence; if he is badly incontinent he may struggle with a 4 hour bus journey so travelling with the catheter in would be easier. On the other hand, flying with a catheter might be a bit awkward.

I doubt very much that he will have a specialist nurse but I would certainly have the number for both urologists saved in your phone.

"Life can only be understood backwards; but it must be lived forwards." Soren Kierkegaard

User
Posted 01 Nov 2020 at 13:31

My OH was very nauseous post op. He was a couple of days in hospital where he felt sick and they gave him anti sickness drugs. When he came home, that first night, he was really bad with nausea. I don't know whether it was the journey home or what but he was awful, really rough. I think if I remember right I came on here in a panic.

He went to bed early and next day was better. That evening he polished off a spag bol so I knew he felt a whole lot better.

He was given Movicol to assist with the toilet and we had lift off on day three, the exact day the surgeon said he would go. But yes, avoid constipation, I've read it can bring tears to eyes and hurts an area that doesn't need extra stress.

Edited by member 01 Nov 2020 at 13:33  | Reason: Not specified

User
Posted 01 Nov 2020 at 14:10

This is probably the general anesthetic. Nausea is a rare side effect in men (but significantly more common in women).

User
Posted 01 Nov 2020 at 14:20

Everyone is different, plus, as Lyn has intimated, different hospitals can have slightly different procedures.

That said I was 68 when I had my RARP in March; I only stayed in overnight and was driven home the next day (less than 24 hours after the op), which was about a 90 minute journey. Obviously was feeling a bit sore and weak, but can't say that it was a problem - apart from when we went over potholes!

I didn't have any special diet, but did have something from the hospital to assist with softer motions for a few days. I don't think a white diet would be appropriate - you want to avoid straining, so you need some roughage. However, you don't want to be up and down either. I just ate my normal diet, which is balanced and healthy anyway. Walking is also a great help in getting you "moving".

I note that he can have the catheter taken out locally, which is good. The 90 minute drive after I had mine taken out was more problematic - had to stop half way so I could dash in and use a supermarket loo!

Edited by member 01 Nov 2020 at 14:21  | Reason: Not specified

User
Posted 01 Nov 2020 at 15:28

If you click on my profile; ‘Bollinge’ to the left of my post, you can read the contemporaneous notes of my virtually pain-free surgery, two and a half years ago, aged 62.

Don’t expect your father to be as anywhere near as lucky as me in my recovery, (but he might be), as others here have not been so fortunate, even with the same brilliant surgeon.

So best of luck to you and your Dad. Come back again if you have any more questions.

Cheers, John.

https://community.prostatecanceruk.org/posts/t16224-Retzius-Sparing-Laparoscopic-Radical-Prostatectomy 

Edited by member 01 Nov 2020 at 15:31  | Reason: Not specified

User
Posted 01 Nov 2020 at 17:18

I just wanted to correct that his **CT (not MRI... my brain is a scrambled mess) showed no signs of spread. 

User
Posted 02 Nov 2020 at 20:25

Hi

Would recommend taking a look at my thread "My Retzius sparing RARP + NeuroSAFE journey by TechGuy"

Largely outcomes are determined by skill and volume experience of the surgeon along with the specifics of the case as each one will have its own unique variables. Plus how quick patient recovers from other impacts like general anaesthetic etc

I had a RARP and was up and about after a day. Then home after my second night in hospital. With minimally invasive surgery the impact was quite minimal in my case. Just have to remember to follow the advice given as its easy to get ahead of yourself and feel better than you do...potentially doing some mischief to the surgery.

Diet wise I was on soups and vege's when I got home. Lactulose syrup also helped a bit with any constipation.

For catheter removable I specifically went to a urology nurse (private) as part of my surgery package for the removal. I didn't want anybody but a specialist doing it given the recently stitched urethra (anastomosis). So long at the nurse is gentle should be fine but I wanted someone who does my 'use-case' on a regular basis.

Hope all goes well and shout if you need anymore info.

S

User
Posted 02 Nov 2020 at 21:58
Inevitably all of us on this forum have our own individual experiences, so all you can do is read them and work out what is possible for your father.

In my case, other than the usual grogginess coming out of anaesthesia, the main problem was pain. I am pretty sure it was "wind" - the rectum, which normally lies just behind the prostate, gets pretty knocked around by the robotic arm. As a result it s very sensitive to being stretched by a "bubble" of wind. But that only lasted a couple of days.

I don't recall any problems with eating. I think when I first came round a nibble on a sandwich was all I wanted, and my grogginess meant drinks with straws or similar involved less effort. However for food, as hinted above, avoid anything that might irritate the bowel, probably best no spicy food.

As described by others, your father will have a catheter until the sewn-up urethra is thought to have sufficiently healed. There may be some quite scary looking clots passed down it, presumably clearing away any bleeding during surgery. Managing a catheter tends to give you a slower pace of life which is no bad thing after an operation, in fact his body will take a while to recover. People tend to forget that a prostatectomy is pretty major surgery even though the incisions may be small, and takes a lot out of the body. Expect your father to want more sleep than usual, possibly for months.

Once the catheter is out, the next problem will be continence, and one thing I have learned from this forum is there has been a wide range of experiences. Some people are continent almost immediately, others improve slowly, and a very few have persistent problems. In most cases continence returns most quickly for the night time. My own personal experience is of initally having days punctuated by frequent pad changes, restricting activities. Slowly those became fewer, though in my case I still need to use a pad over 4 years later (just one a day) whereas others are pad-free.

The other longer term issue is erectile function, not really mentioned yet, and a whole topic of itself. That takes longer to return, assuming the surgeon has been able to preserve the nerves needed. Lots of advice on this forum!

 
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